Evidence map›Paper›PMID 40278905›Full record

ArticleJournal of neurology2025

EEG as a predictive biomarker of neurotoxicity in anti-CD19 CAR T-cell therapy.

Federica Pondrelli, Lorenzo Muccioli, Federico Mason, Corrado Zenesini, Lorenzo Ferri, Gian Maria Asioli, Simone Rossi, Rita Rinaldi, Francesca Rondelli, Marianna Nicodemo and 13 more

Abstract read
In one paragraph

Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Observational
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Federica Pondrelli *IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Lorenzo Muccioli *IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. lorenzo.muccioli@gmail.com.ORCID http://orcid.org/0000-0001-6827-0099
Federico MasonDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Corrado ZenesiniIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Lorenzo FerriIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Gian Maria AsioliIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Simone RossiIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Rita RinaldiIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Francesca RondelliIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Marianna NicodemoIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Roberto D'AngeloIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Valentina BaroneIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Luisa SambatiIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Umberto PensatoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Pier Luigi ZinzaniIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Beatrice CasadeiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Francesca BonifaziIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Enrico MaffiniIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Elisabetta PierucciIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Pietro CortelliIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Paolo TinuperDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Francesca Bisulli *IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Maria Guarino *IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveImmune effector cell-associated neurotoxicity syndrome (ICANS) is a potentially fatal complication of CD19-directed CAR T-cell therapy. The aim of this study was to investigate the role of EEG as a predictive biomarker of ICANS.

methodsIn this prospective, monocentric, cohort study, consecutive refractory B-cell non-Hodgkin lymphoma patients undergoing CAR T-cell therapy had EEG assessments at fixed time points pre- and post-infusion. The risk of ICANS was evaluated according to EEG findings detected qualitatively, using a grading scale ranging from 0 (normal) to 3 (severely abnormal), and quantitatively, using power spectral and connectivity measures.

results307 EEGs from 68 patients have been qualitatively evaluated, of whom 238 were eligible for quantitative analysis. Neurotoxicity manifested in 22/68 (32.4%) patients. Pre-infusion EEG abnormalities (grade 1 and 2) were qualitatively detected in 8/68 (11.7%) patients, emerging as a risk factor for ICANS [HR 5.8 (95%CI 2.6-12.9)]. Quantitative analysis of pre-infusion EEGs did not yield significative results. Post-infusion qualitative EEG abnormalities were associated to a higher risk of ICANS development [HR 11.6 (4.4-30.5) for grade 2; HR 9.7 (2.6-36.6) for grade 3]. Concerning the quantitative analysis, in post-infusion EEGs higher theta energy [HR 1.10 (1.03-1.16)] and delta + theta/alfa ratio [HR 1.37 (1.11-1.67)] were associated to higher risk of ICANS, while higher beta energy resulted protective [HR 0.91 (0.85-0.97)].

conclusionsOur study establishes EEG as a predictive tool for identifying patients at risk for ICANS before CAR T-cell infusion, who may benefit from prophylactic treatments, and anticipating ICANS onset following infusion, enabling early intervention.

Indexed as

Antigens, CD19ElectroencephalographyImmunotherapy, AdoptiveLymphoma, B-CellNeurotoxicity SyndromesAdultAgedBiomarkersCohort StudiesFemaleHumansMaleMiddle AgedProspective StudiesYoung AdultAntigens, CD19BiomarkersBiomarkerChimeric antigen receptor (CAR) T-cell therapyElectroencephalography (EEG)Immune effector cell-associated neurotoxicity syndrome (ICANS)LymphomaQuantitative analysis

Identifiers

PMID40278905
PMCPMC12031834

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.